Saturday, March 11, 2017

Stress Fractures In Teenage Female Runners

Icing the shin

The Singapore National School's competitions are usually held between March and late May every year since 2009. And it's that time of the year again where we see many patients in our clinics with shin splints. Mostly adolescent and teenage girls and the occasional boy.

Why are girls more susceptible to shin splints and stress fractures? Well, some new data shows that if teenage female athletes don't eat enough to support their training, there will be complications regarding their subsequent training and health.

The study tracked 323 female athletes at Stanford University in 16 different sports including cross country running. Bone scans and questionnaires were used to assess the runners based on the components of the "female athlete triad" consisting of "low energy availability, with or without disordered eating, menstrual dysfunction and low bone mineral density. "

Looking only at the cross country runners (47 runners) data, half the runners were classified as low risk, and three of those later developed stress fractures.

Sixteen of the runners had moderate risk and 50 percent of these developed stress fractures within a year. These girls were about four times as likely to get injured compared to the low risk group.

Seven runners were in the high risk group and five of them developed stress fractures. They were nearly six times as likely as the low risk group to get injured.

Well, if you're thinking like me, not so good news for the girls if you're a runner and in the moderate to high risk group.

The researchers suggested the following guidelines for female athletes in the moderate to high risk group. The athletes need to ensure they're getting enough calories to support their training along with calcium and Vitamin D. Their menstrual function, bone health and nutrition needs to be monitored on an ongoing basis.

Higher risk athletes may have to consider using low impact cross training more often in their weekly routine. Good sleep and recovery are important too.

Stress fractures occurred mostly in the foot for the low risk athletes, probably as a consequence of biomechanics and jumping sports (due to higher forces).

In the higher risk categories, many of the stress fractures were in the sacrum, pelvis and femoral neck (where the bones tend to be softer). These areas may be due to weakened bone rather than biomechanical forces.

So all the doctors, physiotherapists, physical education teachers, coaches, heads of departments and administrators in charge of female teenage athletes reading this post, please take note.

Sports Solutions

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About Gino Ng

Prior to joining Physio Solutions and starting up Sports Solutions, Gino Ng worked as a senior sports physiotherapist at the Singapore Sports Council (SSC) from 1999-2009. He graduated with a double masters in Musculoskeletal and Sports Physiotherapy from the University of South Australia on a SSC sponsorship.

Gino's position is perhaps most unique amongst sports physiotherapists in Singapore having seen all sides of the field as a practitioner, an athlete and as a patient.

His special interests are in the treatment of articular cartilage injuries having done research in the area whilst undergoing his postgraduate training. He specializes in treating sports injuries, as well as devising sports rehabilitation programmes after reconstructive surgeries to the shoulder, knee and ankle joints.

As a former national triathlete, Gino is a 2-time Singapore National Triathlon champion (2000-2001), National Duathlon champion (2001), 10-time winner of the National Vertical Marathon (1998-2001, 2004-2005, 2007-2010). He has also placed 4th at the 2001 Asian Duathlon Championships in Hong Kong and made several podium finishes in the Asian Cup Triathlon Series events over the years while holding down a full time job as a physiotherapist.

Partly as a result of his gruelling training regime, Gino needed 3 knee surgeries in 2002 and 2003. After which he made a comeback and placed 4th in the 2005 SEA Games triathlon event.

When not participating, Gino has kept close to sports, travelling widely with the Singapore medical teams for major overseas events such as the various SEA Games, 2002, 2006 Commonwealth Games, the 2006 Asian Games and he is the only local Singaporean physiotherapist to have been to both the 2004 Athens and 2008 Beijing Olympics.

Gino is also one of only two certified Kinesio Taping Instructors (CKTI) in Singapore and teaches the Kinesio Taping Level 1, 2, 3 & 4 courses. He is also a frequent speaker at symposiums and sporting events.

While out cycling in April 2013, Gino had an accident and fractured his skull and spine. Thankfully, he is a lot better now and is back working part time. Having neck and back pain? Well, now you know who came back from a broken skull and back.